| NPI | 1487180642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A157351) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A157251) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2022-02-07 |